Wednesday, May 30, 2007

IHRT Doesn't Think Sooooooo...Do YOU?

IHRT doesn't think soooooo................... do you??

Posted Sunday, May 27, 2007 @ 10:01 AM

We have got a new general surgeon at the Klinik am Zuckerberg in Braunschweig.
Together with him we are going to perform by gasless Lift-Laparoscopy beside general surgical procedures like gallbladder, hernias and other surgeries also cases with bowel endometriosis and those adhesion cases, requiering a bowel resection. I will come back with more information soon
Regards --------------------Daniel Kruschinski, MD,,,,, © by EndoGyn Ltd.

IHRT points out that....

Visit the Zuckerberg web site after reading our points and email them with your questions too:

1.) There are NO "General" surgeons listed in the Zuckerberg web site! New or otherwise!

2.) Zuckerberg does not offer any "general" surgical procedures, at least not any listed in the web site!

3.) Endogyn does not list any "new" physicians who have joined Endogyn!

4.) Endogyn has not mentioned if the physicians listed in Endogyn still perform surgery there..there meaning where ever "Endogyn" is located, or what "Endogyn" is exactly.

5.) There is no mention that Kruschinski actually performs surgery in Zuckerberg, and no contacts can be made to him at Zuckerberg.

6.) No more Endogyn LTD,

7.) No more pictures of patients surgeries

8.) No more "SLL" = second look laporoscopic procedures

9.) No more mention of using "Spraygel,"

10.) No more additional patients on the "patient contact list in Endogyn. (And no, it is not due to IHRT as if that were the case, there would be no names listed publicly!)

11.) No address for "Endogyn" home office or whatever.

12.) No "Endogyn" listed as a business in Germany.

13.) The "email" that appeared to come from Jochen actually came from Kruschinski.

14.) No telephones or computers at Zuckerberg, Kruschnski sad so himself, remember? (But they do have a chef!)

15.) No Kruschinski performing ANY surgery in Zuckerberg on Monday, May 21, 2007!

The list can go on and on and on......but for now, these "points" might give folks food for thought as to just how "forthcoming" Kruschinski has been.

Why not contact Daniel Kruschinski and ask him any questions you might have about the issues found in IHRT!

Contact in Endogyn web site:

eMail address's:

Contact in Endosurgery web site:

Bowel resection

Bowel resection is a surgical procedure in which a diseased part of the large intestine is removed. The procedure is also known as colectomy, colon removal, colon resection, or resection of part of the large intestine.
The large bowel, also called the large intestine, is a part of the digestive system. It runs from the small bowel (small intestine) to the rectum, which receives waste material from the small bowel. Its major function is to store waste and to absorb water from waste material. It consists of the following sections, any of which may become diseased:
Colon. The colon averages some 60 in (150 cm) in length. It is divided into four segments: the ascending colon, transverse colon, descending colon, and sigmoid colon. There are two bends (flexures) in the colon. The hepatic flexure is where the ascending colon joins the transverse colon. The splenic flexure is where the transverse colon merges into the descending colon.
Cecum. This is the first portion of the large bowel that is joined to the small bowel. The appendix lies at the lowest portion of the cecum.
Ascending colon. This segment is about 8 in (20 cm) in length, and it extends upwards from the cecum to the hepatic flexure near the liver.
Transverse colon. This segment is usually more than 18 in (46 cm) in length and extends across the upper abdomen to the splenic flexure.
Descending colon. This segment is usually less than 12 in (30 cm) long and extends from the splenic flexure downwards to the start of the pelvis.
Sigmoid colon. An S-shaped segment that measures about 18 in (46 cm); it extends from the descending colon to the rectum.
The wall of the colon is composed of four layers:
Mucosa. This single layer of cell lining is flat and regenerates itself every three to eight days. Small glands lie beneath the surface.
Submucosa. The area between the mucosa and circular muscle layer that is separated from the mucosa by a thin layer of muscle, the muscularis mucosa.
Muscularis propria. The inner circular and outer longitudinal muscle layers.
Serosa. The outer, single-cell, thick covering of the bowel. It is similar to the peritoneum, the layer of cells that lines the abdomen.
The large intestine is also responsible for bacterial production and absorption of vitamins. Resection of a portion of the large intestine (or of the entire organ) may become necessary when it becomes diseased. The exact

To remove a portion of the colon, or large intestine, and incision is made in the abdomen to expose the area (A). Tissues and muscles connecting the colon to surrounding organs are severed (B). The area to be removed is clamped and severed (C). The remaining portions of the bowel, the ileum (small intestine) and transverse colon, are connected with sutures (D). Muscles and tissues are repaired (E). (
Illustration by GGS Inc.) reasons for large bowel resection in any given patient may be complex and are always carefully evaluated by the treating physician or team. The procedure is usually performed to treat the following disorders or diseases of the large intestine:
Cancer. Colon cancer is the second most common type of cancer diagnosed in the United States. Colon and rectum cancers, which are usually referred to as colorectal cancer, grow on the lining of the large intestine. Bowel resection may be indicated to remove the cancer.
Diverticulitis. This condition is characterized by the inflammation of a diverticulum, especially of diverticula occurring in the colon, which may undergo perforation with abscess formation. The condition may be relieved by resecting the affected bowel section.
Intestinal obstruction. This condition involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through. It is usually treated by decompressing the intestine with suction, using a nasogastric tube inserted into the stomach or intestine. In cases where decompression does not relieve the symptoms, or if tissue death is suspected, bowel resection may be considered.
Ulcerative colitis. This condition is characterized by chronic inflammation of the large intestine and rectum resulting in bloody diarrhea. Surgery may be indicated when medical therapy does not improve the condition. Removal of the colon is curative and also removes the risk of colon cancer. About 25–40% of ulcerative colitis patients must eventually have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer.
Traumatic injuries. Accidents may result in bowel injuries that require resection.
Pre-cancerous polyps. A colorectal polyp is a growth that projects from the lining of the colon. Polyps of the colon are usually benign and produce no symptoms, but they may cause rectal bleeding and develop into malignancies over time. When polyps have a high chance of becoming cancerous, bowel resection may be indicated.
Familial adenomatous polyposis (FAP). This is a hereditary condition caused by a faulty gene. Most people discover that they have it at a young age. People with FAP grow many polyps in the bowel. These are mostly benign, but because there are so many, it is really only a question of time before one becomes cancerous. Since people with FAP have a very high risk of developing bowel cancer, bowel resection is thus often indicated.
Hirschsprung's disease (HD). This condition usually occurs in children. It causes constipation, meaning that bowel movements are difficult. Some children with HD cannot have bowel movements at all; the stool creates a blockage in the intestine. If HD is not treated, stool can fill up the large intestine and cause serious problems such as infection, bursting of the colon, and even death.
Bowel resection can be performed using an open surgical approach (colectomy) or laparoscopically.
Following adequate bowel preparation, the patient is placed under general anesthesia, which ensures that the patient is deep asleep and pain free during surgery. Because the effects of gravity to displace tissues and organs away from the site of operation are important, patients are carefully positioned, padded, and strapped to the operating table to prevent movement as the patient is tilted to an extreme degree. The surgeon starts the procedure by making a lower midline incision in the abdomen or, alternatively, he may prefer to perform a lateral lower transverse incision instead. He proceeds with the removal of the diseased portion of the large intestine, and then sutures or staples the two healthy ends back together before closing the incision. The amount of bowel removed can vary considerably, depending on the reasons for the operation. When possible, the procedure is performed to maintain the continuity of the bowel so as to preserve normal passage of stool. If the bowel has to be relieved of its normal digestive work while it heals, a temporary opening of the colon onto the skin of abdominal wall, called a colostomy, may be created. In this procedure, the end of the colon is passed through the abdominal wall and the edges are sutured to the skin. A removable bag is attached around the colostomy site so that stool may pass into the bag, which can be emptied several times during the day. Most colostomies are temporary and can be closed with another operation at a later date. However, if a large portion of the intestine is removed, or if the distal end of the colon is too diseased to reconnect to the proximal intestine, the colostomy is permanent.
Laparoscopic bowel resection
The benefits of laparoscopic bowel resection when compared to open colectomies include reduced postoperative pain, shorter hospitalization periods, and a faster return to normal activities. The procedure is also minimally invasive. When performing a laparoscopic procedure, the surgeon makes three to four small incisions in the abdomen or in the umbilicus (belly button). He inserts specialized surgical instruments, including a thin, telescope-like instrument called a laparoscope, in an incision. The abdomen is then filled with gas, usually carbon dioxide, to help the surgeon view the abdominal cavity. A camera is inserted through one of the tubes and displays images on a monitor located near the operating table to guide the surgeon as he works. Once an adequate view of the operative field is obtained, the actual dissection of the colon can start. Following the procedure, the small incisions are closed with sutures or surgical tape.
All colon surgery involves only three maneuvers that may vary in complexity depending on the region of the bowel and the nature of the disease. These three maneuvers are:
retraction of the colon
division of the attachments to the colon
dissection of the mesentery
In a typical procedure, after retracting the colon, the surgeon proceeds to divide the attachments to the liver and the small bowel. Once the mesenteric vessels have been dissected and divided, the colon is divided with special stapling devices that close off the bowel while at the same time cutting between the staple lines. Alternatively, a laparoscopically assisted procedure may be selected, in which a small abdominal wall incision is made at this point to bring the bowel outside of the abdomen, allowing open bowel resection and reconnection using standard instruments. This technique is popular with many surgeons because an incision must be made to remove the bowel specimen from the abdomen, which allows the most time-consuming and risky parts of the procedure (from an infection point of view) to be done outside the body with better control of the colon.
Key elements of the physical examination before surgery focus on a thorough examination of the abdomen, groin, and rectum. Other common diagnostic tools used to evaluate medical conditions that may require bowel resection include imaging tests such as gastrointestinal barium series, angiography, computerized tomography (CT), magnetic resonance imaging (MRI), and endoscopy.
As with any surgery, the patient is required to sign a consent form. Details of the procedure are discussed with the patient, including goals, technique, and risks. Blood and urine tests, along with various imaging tests and an electrocardiogram (EKG), may be ordered. To prepare for the procedure, the patient is asked to completely clean out the bowel. This is a crucial step if the bowel is to be opened safely within the peritoneal cavity, or even manipulated safely through small incisions. To empty and cleanse the bowel, the patient is usually placed on a low-residue diet for several days prior to surgery. A liquid diet may be ordered for at least the day before surgery, with nothing taken by mouth after midnight. A series of enemas and/or oral preparations (GoLytely or Colyte) may be ordered to empty the bowel of stool. Preoperative bowel preparation involving mechanical cleansing and administration of intravenous antibiotics immediately before surgery is the standard practice. The patient may also be given a prescription for oral antibiotics (neomycin, erythromycin, or kanamycin sulfate) the day before surgery to decrease bacteria in the intestine and to help prevent post-operative infection. A nasogastric tube is inserted through the nose into the stomach during surgery and may be left in place for 24–48 hours after surgery. This removes the gastric secretions and prevents nausea and vomiting. A urinary catheter (a thin tube inserted into the bladder) may be inserted to keep the bladder empty during surgery, giving more space in the surgical field and decreasing chances of accidental injury.
Postoperative care for the patient who has undergone a bowel resection, as with those who have had any major surgery, involves monitoring of blood pressure, pulse, respiration, and temperature. Breathing tends to be shallow because of the effect of anesthesia and the patient's reluctance to breathe deeply and experience pain that is caused by the abdominal incision. The patient is instructed how to support the operative site during deep breathing and coughing, and is given pain medication as necessary. Fluid intake and output is measured, and the operative site is observed for color and amount of wound drainage. The nasogastric tube will remain in place, attached to low intermittent suction until bowel activity resumes. Fluids and electrolytes are infused intravenously until the patient's diet can gradually be resumed, beginning with liquids and advancing to a regular diet as tolerated. The patient is generally out of bed approximately eight to 24 hours after surgery. Most patients will stay in the hospital for five to seven days, although laparoscopic surgery can reduce that stay to two to three days. Postoperative weight loss follows almost all bowel resections. Weight and strength are slowly regained over a period of months. Complete recovery from surgery may take two months. Laparoscopic surgery can reduce this time to one to two weeks.
The treating physician should be informed of any of the following problems after surgery:
increased pain, swelling, redness, drainage, or bleeding in the surgical area
headache, muscle aches, dizziness, or fever
increased abdominal pain or swelling, constipation, nausea or vomiting, rectal bleeding, or black, tarry stools
Potential complications of bowel resection surgery include:
excessive bleeding
surgical wound infection
incisional hernia (an organ projecting through the surrounding muscle wall, it occurs through the surgical scar)
thrombophlebitis (inflammation and blood clot to veins in the legs)
narrowing of the opening (stoma)
pulmonary embolism (blood clot or air bubble in the lung blood supply)
reaction to medication
breathing problems
obstruction of the intestine from scar tissue
Normal results
Complete healing is expected without complications after bowel resection, but the period of time required for recovery from the surgery varies depending on the initial condition that required the procedure, the patient's overall health status prior to surgery, and the length of bowel removed.
Morbidity and mortality rates
Prognosis for bowel resection depends on the seriousness of the disease. For example, primary treatment for colorectal cancer consists of wide surgical resection of the colon cancer and lymphatic drainage after the bowel is prepared. The choice of operation for rectal cancer depends on the tumor's distance from the anus and gross extent; overall surgical cure is possible in 70% of these patients. In the case of ulcerative colitis patients, the colitis is cured by bowel resection and most people go on to live normal, active lives. As for Hirschsprung's disease patients, approximately 70–85% eventually achieve excellent results after surgery, with normal bowel habits and infrequent constipation.
Alternatives to bowel resection depend on the specific medical condition being treated. For most conditions where bowel resection is advised, the only alternative is medical treatment with drugs. In cases of cancer of the bowel, drug treatment alone will not cure the disease. Occasionally, it is possible to remove a rectal cancer from within the back passage without major surgery, but this only applies to very special cases. As for other conditions such as mild or moderate ulcerative colitis, drug therapy may represent an alternative to surgery; a combination of the drugs sulfonamide, sulfapyridine, and salicylate may help control inflammation. Similarly, most acute cases of diverticulitis are first treated with antibiotics and a liquid diet.
See also Laparoscopy; Small bowel resection.
Corman, M. L. Colon and Rectal Surgery. Philadelphia: Lippincott Williams & Wilkins, 1998.
Hampton, Beverly, and Ruth Bryant. Ostomies and Continent Diversions. St. Louis: Mosby Inc., 1992.
Michelassi, F., and J. W. Milsom, eds. Operative Strategies in Inflammatory Bowel Disease. New York: Springer Verlag, 1999.
Peppercorn, Mark, ed. Therapy of Inflammatory Bowel Disease: New Medical and Surgical Approaches. New York: Marcel Dekker, 1989.
Alves, A., Y. Panis, D. Trancart, J. Regimbeau, M. Pocard, andP. Valleur. "Factors Associated with Clinically Significant Anastomotic Leakage after Large Bowel Resection: MultivariateAnalysis of 707 Patients." World Journal of Surgery 26 (April 2002): 499–502.
Miller, J., and A. Proietto. "The Place of Bowel Resection in Initial Debulking Surgery for Advanced Ovarian Cancer." Australian and New Zealand Journal of Obstetrics and Gynaecology 42 (November 2002): 535–537.
Sukhotnik, I., A. S. Gork, M. Chen, R. Drongowski, A. G. Coran, and C. M. Harmon. "Effect of Low Fat Diet on Lipid Absorption and Fatty-acid Transport following Bowel Resection." Pediatric Surgery International 17 (May 2001): 259–264.
Tabet, J., D. Hong, C. W. Kim, J. Wong, R. Goodacre, and M. Anvari. "Laparoscopic versus Open Bowel Resection for Crohn's Disease." Canadian Journal of Gastroenterology 15 (April 2001): 237–242.
Taylor, C., and C. Norton. "Information Booklets for Patients with Major Bowel Resection." British Journal of Nursing 19 (June–July 2000): 785–791.
American Board of Colorectal Surgeons (ABCRS). 20600 Eureka Rd., Ste. 600, Taylor, MI 48180. (734) 282-9400. .
The American Society of Colorectal Surgeons (ASCRS). 85 West Algonquin, Suite 550, Arlington Heights, IL 60005. (847) 290 9184. .
United Ostomy Association, Inc. (UOA). 19772 MacArthur Blvd., Suite 200, Irvine, CA 92612-2405. (800) 826-0826. .
"Bowel Resection." Patient & Family Education / NYU Medical Center. http://.
"Bowel Resection with Colostomy." Health Care Corporation of St. John's. http://.
"Colorectal Cancer." ASCRS Homepage. http://.
Kathleen D. Wright, RN Monique Laberge, PhD
Bowel resection surgery is performed by a colorectal surgeon, who is a medical doctor fully trained in general surgery and certified by the American Board of Surgery (ABS) as well as by the American Society of Colon and Rectal Surgeons (ASCRS). The surgeon must pass the American Board of Surgery Certifying Examination and complete an approved colorectal training program. The surgeon is then eligible to take the qualifying examination in colorectal surgery after completing training. There is also a certifying examination that is taken after passing the qualifying examination. The surgeon is required to re-certify in surgery in order to re-certify in colon and rectal surgery (every 10 years).
Bowel resection surgery is a major operation performed in a hospital setting. The cost of the surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are sicker or need more extensive surgery will require more intensive and expensive treatment.
What alternatives to bowel resection might be indicated in my case?
Am I a candidate for bowel resection?
How many patients with my specific condition have you treated?
How long will it take to recover from surgery?
What do I need to do before surgery?
What happens on the day of surgery?
What type of anesthesia will be used?
What happens during surgery, and how is the surgery performed?
Source with forum

Tuesday, May 29, 2007

Adhesions Medical News ARD vark Blog Updates Information On Health Coverage, Uninsured, Medicaid, SCHIP; Report Makes Recommendations To Improve Part D For Sickest

Kaiser Daily Health Policy Report Highlights Recent Developments Related To Medical Malpractice In Two States

Many Small Physician Offices No Longer Provide Injected Medications Because Of Medicare Reimbursement Issues

Long-Term Extension Of Ulcerative Colitis Study Shows REMICADE® Responders Maintained Improvement Through Two Years Of Follow-Up

Improved Early Detection Of Colorectal Cancer Made Possible By Advances In Screening And Markers

COX Inhibitors May Weaken Protective Qualities Of Estrogen Hormone Therapy

Long-Term Safety Study Of LIALDA Shows Ulcerative Colitis Remission Rates

Can You Heal From Chronic Fatigue?

What Is Really Important When You Are Depressed?

Link Between Gastric Bypass Surgery And Neurological Conditions

Smart Pill Saves Time And Invasive Procedures In Diagnosing Stomach Problems

Contributing factors that could prevent patients from getting optimal results from their colonoscopy

Colonoscopies are considered the gold standard for detecting colon cancer, the second leading cause of cancer deaths in the United States. Research presented at Digestive Disease Week® 2007 (DDW®) discusses contributing factors that could prevent patients from getting optimal results from their colonoscopy, including age of the patient, location of the screening and proper technician training.
DDW is the largest international gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

Adequate Level of Training for Technical Competence in Colonoscopy: A Prospective Multicenter Evaluation of the Learning Curve (Abstract # 659)

For a physician to be considered "competent" at diagnostic colonoscopies, training programs recommend that trainees complete between 100 and 200 procedures. This study conducted by researchers from the Soonchunhyang University College of Medicine in Korea argues that there are other markers of competency, most notably cecal intubation (the process of inserting of a tube into the first portion of the large bowel), which has been known to cause complications if it takes too long. Investigators evaluated the procedures of 24 first-year fellows in 15 tertiary care academic centers - a total of 4,351 colonoscopies. Procedures were excluded if they were related to the following: emergency colonoscopies, colonic obstructions, previous histories of colonic operations, therapeutic procedures, monitoring for inflammatory bowel disease (IBD) and age (no one older than 80 or younger than 18). The success rate was measured by the completion rate (greater than 90%) and the cecal intubation time (less than 20 minutes).
After examining the completion rate and the cecal intubation time, the team concluded that competence in efficient colonoscopy generally requires more than 150 cases. Overall, 83.5 percent of the colonoscopies were successful and the average cecal intubation time was 9.23 minutes. The success rate was significantly improved and reached the competency standard after 150 procedures (71.5, 82.6, 91.3, 94.4, 98.4 and 98.7%, respectively, for every 50 procedures). After 150, procedures cecal intubation time decreased from 14.2 to nine minutes.

"We feel this study was extremely valuable in further assessing the level of technical competency that will minimize patient complications when undergoing colonoscopy," said Suck-Ho Lee of the Soonchunhyang University College of Medicine, and lead author of the study.

"We hope that institutions will be cognizant of these statistics as they train new technicians in order to obtain the best results for our patients with the least risk possible.

" Incomplete Colonic Examination in the Elderly: A Consequence of Inadequate Preparation (Abstract #W1275)

The use of endoscopy has rapidly increased in the elderly over the past few years as research has verified its safety and efficacy. Colonoscopies have also proven to be safe for the elderly, but are often more technically challenging than endoscopies due to inadequate preparation and the safe administration of sedatives. This study, conducted by researchers from the Imperial College Faculty of Medicine in London, sought to determine the effectiveness of colonoscopy for complete examination of the colon in patients over the age of 75. All colonoscopies were performed in a teaching hospital throughout a one-year period and were analyzed for rates of complete examination, as defined by cecal intubation and the ability to obtain a full image of the area at the beginning of the colon near the small intestines. Overall, 1,981 colonoscopies were performed, and only 11.8 percent of patients under the age of 75 had incomplete examinations. However, that number increased to 20.7 percent in those over the age of 75. The leading reason for unsuccessful examinations was poor preparation (42.5%). Contrary to popular belief, just 0.7 percent of the colonoscopies were stopped due to discomfort in patients over 75, as opposed to 2.6 percent in those under 75.
"Colonoscopy in a population over 75 years of age is less successful in imaging the colon, mainly due to problems with bowel preparation. However, contrary to popular belief, aborted examinations due to discomfort in the elderly are rare," said Kinesh Patel, MBBS, of Imperial College Faculty of Medicine, and lead author of the study.
"Strategies to improve bowel preparation will help increase the effectiveness of colonoscopy in this population. Additionally, further studies on bowel preparation are urgently required to optimize the safety and efficacy of colonoscopy in a vulnerable patient group."

Process Quality Indicators in a Series of 145,401 Outpatient Colonoscopies (Abstract #W1238)
As more and more people rely on colonoscopies for the prevention and early detection of colon cancer, it is crucial that researchers assess the process quality of colonoscopies and identify factors associated with poor quality, specifically in outpatient colonoscopies. Investigators from the University of Munich in Germany analyzed a database containing details of 145,401 colonoscopies performed by the Compulsory Health Insurance Physicians in Bavaria, Germany from January through September of 2006 for these quality indicators. Of the patients examined, 110,648 had a clean enough bowel to perform the colonoscopies and only 3,976 examinations were considered incomplete. Most of the examinations (n=134,655) were taken with a sedative. Incomplete exams were largely due to adhesions (scar tissues that attach to the surfaces of organs, n=512), impassable stenosis (narrowing of the gut, n=506), long and curved colon (n=284), and additional complications (n=50). While male and sedated patients were more likely to have a complete colonoscopy, older patients were less likely to complete the procedure. "For the first time, we report findings for a large range of process quality indicators for outpatient colonoscopies," said Berndt Birkner, M.D., a gastroenterologist from the Munich study team.
"They may serve as a benchmark for comparisons with other programs. Sedation and thorough bowel cleansing are modifiable factors conducive to the completeness of colonoscopies and can play a critical role in the ultimate outcome for these patients."

### Digestive Disease Week® (DDW®) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT). The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.
Contact: Aimee Frank
American Gastroenterological Association

Monday, May 28, 2007

In Memoriam

We remember these women, who died from complications related to their Adhesions Related Disorder, may they also represent the many who
die without ever knowing what caused their deaths:

Christina Buelteman died January 2000 Menominee, Michigan, (8 years of suffering with ARD) Age 42

Marian Lewis died July 26, 2000 Odessa, Florida (42 years of suffering with ARD) In her 60’s

Cindy McAleer ("Bear")...died June 11, 2000 age 37

Susan Stransky died February 14, 2000 Florida (7 years of suffering with ARD) In her 30’s

Marjorie Lee Wantz died October 23, 1991 Sodus, Michigan age 58

Tammy Wynette died April 6, 1998 age 55

Rochelle “Shellie” S. Sabowski died July 13, 2003 (10 years of suffering with ARD) age 38

Thursday, May 24, 2007

Adhesion Headlines ARDvark Blog

Washington Post Magazine Examines Selective-Reduction Procedure For Pregnancies With Multiple Fetuses

Judicial Watch Uncovers Three Deaths Relating To HPV Vaccine

Capsule Endoscopy Is Effective In Diagnosing Childhood GI Problems

New Medications Needed For Neuropathic Pain

New Prevention, Treatment Methods For Patients With Painful Bowel Inflammation

CervarixTM Is Approved In Australia For Females 10-45 Years Old - 1st Major Market Licence For GSK Cervical Cancer Vaccine

Researchers Investigate Impact Of Lifestyle On GI Health

Constipation, IBS In Women May Be Alleviated By Novel Treatments

93 Lawmakers Sign Letter To Pelosi Asking For Legislative Action To Cut Contraception Prices

Positive Clinical Data On CC-10004 Confirms Potential As Novel Oral Approach To Treating Inflammatory Diseases

Cepheid's Xpert(TM) MRSA Test Categorized As 'Moderate Complexity' By FDA

More Difficult For Doctors To Diagnose Complex Sources Of Pain In Women Than In Men

Smokeless Cannabis Delivery Device Efficient And Less Toxic

BEMA Fentanyl Demonstrates Substantial Transmucosal Delivery

Surgeries To Treat Urinary Incontinence In Women Compared In Nationwide Study

Interaction Of Non-steroidal Anti-inflammatory Drugs And Hormone Replacement Therapy

Menopause And Insomnia -- New Findings Link Estrogen Decline, Sleeplessness And Mineral Deficiency

New technique effective in closing accidental colonoscopy wounds

WASHINGTON, D.C. -- To prevent colon cancer, the second leading cause of United States cancer deaths, the American Cancer Society recommends that after age 50 people undergo colonoscopies every ten years to detect signs of that disease — either actual tumors or precancerous polyps.But in one out of every 1,000 to 2,000 colonoscopies, doctors inadvertently perforate — or puncture — the colon. Most of these patients need urgent surgery to close the wound and spend 10 days in the hospital. One in 10 dies, usually because delays in closing perforations allow colon contents to leak into the abdominal cavity, causing deadly conditions such as peritonitis and sepsis.Now, however, in a series of animal studies, researchers at the University of Texas Medical Branch at Galveston (UTMB) have developed a technique for closing perforations promptly after they are recognized by using clips or sutures that can be inserted through the anus via endoscope, thus avoiding invasive surgery. Similar clips and sutures have been used for some time by surgeons performing minimally invasive laparoscopic procedures — including several gynecological operations and other procedures such as gall bladder removal.Today [Wednesday, May 23, 2007] at the annual meeting of the American Society of Gastrointestinal Endoscopy, UTMB professor G.S. Raju, the principal investigator for the wound-repair studies, presented a summary of his experimental endoscopic research over the last three years.Working with pigs as an experimental model, Raju and his team first successfully closed colon perforations of less than one inch with small metal clips inserted via endoscopes.During colonoscopies, surgeons accidentally may cause two principal types of perforations, Raju explained. One results from over-stretching the colon, the other from removal of polyps. (Incomplete removal of polyps may cause adhesions, in which the remaining portion of the polyp sticks to the colon wall.) "We have shown in a series of experiments that both types of perforations can be closed successfully using an endoscope without the need for invasive surgery," Raju reported. He added: "We have even accomplished a leak-proof seal of the perforation."Encouraged by the preliminary work done at UTMB, InScope, a branch of Ethicon Endosurgical of Cincinnati, invited Raju to initiate and lead a multi-center animal study comparing surgical closure with endoscopic efforts to close a gaping, 1.6-inch-wide colon perforation using new clips and sutures. Other institutions joining in the multi-center trial included academic medical centers at Dartmouth University and the University of Cincinnati, and at medical schools in Great Britain and Sweden. "The results are encouraging," Raju said: "As good as surgery in closing perforations, better than surgery in reducing adhesions.""Experience gained from laboratory experiments was quickly used to improve patient care at UTMB," Raju noted. "Recently, two patients who were not good candidates for surgery were successfully treated at UTMB for postoperative leaks following esophageal and colon cancer surgery using the clip technology."Raju said he expects that by next year, experience gained in the laboratory will allow his UTMB surgical colleagues Drs. Guillermo Gomez and William Nealon to help patients with gastrointestinal perforations and postoperative leaks. In addition, he said those surgeons hope to explore the role of endoscopy in treating patients with gastrointestinal tumors. He predicts that the minimally invasive endoscopic procedures will help such patients experience less pain, faster healing, less hospital time and lower medical costs, as is the case with laparoscopic procedures.As for colon wound repair, Raju said if human clinical trials are as successful as those done in pigs, he would expect these procedures to be commonly adopted in hospitals in the near future.Raju said the UTMB Center for Endoscopic Research, Training and Innovation, (CERTAIN), which he directs, plans to develop courses to train physician colleagues in the region in how to use clips and sutures to close perforations.

Tuesday, May 22, 2007

ARDvark Blog Adhesion News

Safer medical, Australia - May 20, 2007Such adhesions often lead to scarring and new blockages - a process known as restenosis. Inflammation is the body's natural response to harmful stimuli, ...

Florida State Unversity Researchers Reap 1-Million Dollar Grant To ...Medical News Today (press release), UK - May 18, 2007Such adhesions often lead to scarring and new blockages - a process known as restenosis. Inflammation is the body's natural response to harmful stimuli, ...

Jury can’t decide malpractice trialEdwardsville Intelligencer, IL - May 16, 2007While it is a common method, it should not have been used in Baugus’ situation because she had adhesions from earlier caesarean sections. ...

Nigeria: Abortion - Must Millions of Women Die Annually?, Washington - May 14, 2007All her pelvic organs and intestines were bound down by adhesions and were not readily mobilisable. The vulva was smeared with blood, the cervix was ...

Monday, May 07, 2007

Adhesions Medical Headlines ARDvark Blog

New Therapy For Patients With Crohn's Disease Identified By Researchers

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SyntheMed Appoints Marc Sportsman as Vice President of Sales

ISELIN, N.J., May 2 /PRNewswire-FirstCall/ -- SyntheMed, Inc. (OTC
Bulletin Board: SYMD), a biomaterials company engaged in the development
and commercialization of anti-adhesion and drug delivery products, today
announced the appointment of Marc R. Sportsman to the newly-created
executive officer position of Vice President of Sales. Mr. Sportsman brings
to the Company over twenty years of sales experience in the cardiac device
industry. He most recently served as Vice President of Sales at ATS
Medical, Inc. and held previous sales positions of increasing
responsibility with St. Jude Medical, Inc. and Shiley, Inc. Mr. Sportsman's
responsibilities will include the recruitment of a field sales organization
and development of sales strategy, programs and procedures in support of
the planned US launch of REPEL-CV(R) Adhesion Barrier, the Company's novel
anti-adhesion product designed for use in cardiothoracic surgical
procedures. On March 28, 2007, the Company announced that the US Food and
Drug Administration (FDA) accepted for review the Company's Pre-market
Approval (PMA) application for REPEL-CV.
Robert P. Hickey, SyntheMed's President & CEO stated, "We are extremely
fortunate to have attracted a sales executive of Marc's caliber to this
critically important position. The Company will immediately benefit from
Marc's extensive experience in cardiac device sales and his broad network
of relationships with cardiac surgeons, clinical support staff and hospital
administration. Our first opportunity to leverage Marc's background will be
at next week's American Association of Thoracic Surgery convention in
Washington, DC at which SyntheMed will be featuring REPEL-CV."
About Adhesions
Adhesions, or scar tissue, occur after virtually all open-heart
surgical procedures, often resulting in the heart becoming attached to the
sternum and other surround tissue surfaces. The presence of adhesions
represents a prevalent and serious complication in secondary surgical
procedures, increasing the length, cost and risk of the surgical procedure.
There are an estimated 500,000 open heart surgeries performed annually in
the United States, and another 350,000 estimated in the European Union. In
both markets, approximately 15-20 percent of these surgeries are secondary
REPEL-CV is a bioresorbable adhesion barrier film designed to be placed
over the surface of the heart at the conclusion of the open-heart surgical
procedure to reduce the extent and severity of adhesions that form between
the surface of the heart and the inner surface of the sternum following the
surgical procedure. REPEL-CV is designed to provide the therapeutic benefit
and then degrade so that it is cleared from the surgical site. REPEL-CV is
marketed internationally and may be launched in the US, pending FDA
approval, during the second half of 2007.
About SyntheMed, Inc.
SyntheMed, Inc. is a biomaterials company engaged in the development
and commercialization of anti-adhesion and drug delivery products. The
Company is primarily focused on the advancement and expansion of product
development programs based on its proprietary bioresorbable polymer
Statements in this Press Release that are not statements of historical
fact, including statements regarding indications of the timing or ability
to achieve regulatory approval and market launch for REPEL-CV or the
potential market size for REPEL-CV, constitute "forward-looking statements"
within the meaning of the Private Securities Litigation Reform Act of 1995.
Such forward-looking statements involve known and unknown risks,
uncertainties and other factors which may cause the actual results,
performance or achievements of the Company, or industry results, to be
materially different from any future results, performance, or achievements
expressed or implied by such forward-looking statements. Such risks and
uncertainties include but are not limited to (i) potential adverse
developments regarding the Company's efforts to obtain and maintain
required FDA and other regulatory approvals; (ii) potential inability to
secure funding as and when needed to support the Company's future
activities and (iii) unanticipated delays associated with manufacturing and
marketing activities. Reference is made to the Company's Annual Report on
Form 10-KSB for the year ended December 31, 2006 for a description of
these, as well as other, risks and uncertainties.

SOURCE SyntheMed, Inc.

Key Patents Issued for Arcad Instillate for the Prevention of Surgical Adhesions

VANCOUVER, British Columbia, May 4, 2007 – The University of British Columbia (UBC) and ARC Pharmaceuticals Inc. (ARC) today announced that key patents relating to ARC's lead product candidate, Arcad Instillate, for the prevention and treatment of surgical adhesions, were recently issued or granted in several territories. The patents are assigned to UBC and ARC previously in-licensed these technologies through an exclusive worldwide license agreement with UBC.
USA Patent # 7,163,930, Australia Patent # 2002325113 and New Zealand Patent # 532015 were recently issued and China Patent # 02816693.0 was granted and will be registered in Hong Kong. These patents are in addition to the earlier issued USA Patent # 6,812,220 and a portfolio of related patent applications in additional territories. The patents relate to the use of fucans including fucoidan for the prevention and treatment of surgical adhesions and/or fibrous adhesions. Fucoidan is the key component of ARCAD™ Instillate.
ARC has demonstrated in several different preclinical models of surgical adhesions that the use of ARCAD™ Instillate resulted in a significant reduction in the number and severity of post-surgical adhesions,” said Chris Springate, President and CEO of ARC.
About ARCAD™ technology – The key component of ARCAD™ Instillate is a fucan known as fucoidan. Fucoidan is a naturally occurring polysaccharide and is extracted from seaweed or brown marine algae. ARC has purified and incorporated fucoidan into the Company's proprietary lead product candidate, ARCAD™ Instillate, for the prevention of surgical adhesions. ARC has also commenced exploration of the use of the ARCAD™ technology in other disease indications and has formulated ARCAD™ as a gel and as a film.
About ARC Pharmaceuticals Inc. – ARC Pharmaceuticals Inc. is developing innovative medical products for the prevention and treatment of surgical adhesions, a major complication in a high proportion of common surgical procedures. Further potential opportunities exist for the technology in the management of arthritis and psoriasis.
Statements contained in this press release that are not based on historical fact, including without limitation statements containing the words "will", "plans", "could", "may", "expects", "intends", "anticipates", "continue", "estimate" and similar expressions constitute "forward-looking statements". All such statements are made pursuant to the "safe harbor" provisions of applicable securities legislation. Forward-looking statements may involve without limitation comments with respect to the Company's research and development and commercialization objectives including product candidates for surgical adhesions, arthritis and psoriasis, intellectual property including patents, and business strategies and objectives. Forward-looking statements involve known and unknown risks and uncertainties including risks and uncertainties beyond the Company's control, which may cause the actual results to be materially different from any future results expressed or implied by forward-looking statements. Given these risks, uncertainties and assumptions, readers are cautioned not to place undue reliance on forward-looking statements and the Company claims not to be under any obligation to update or announce the result of any revisions to any forward-looking statements to reflect future results.
Contact Information:
Chris Springate President and CEO ARC Pharmaceuticals Inc. Tel: 604-222-9577 Fax: 604-222-9578

Tuesday, May 01, 2007

Adhesons Medical News ARDvark Blog

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The Link Between Malnutrition And Infection

Far More Women Getting MS Than Men American Study Finds

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Physician Ties To Drug Industry Stronger Than Ever

Dingell, Kennedy Introduce 'Medicare For All' Bill

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Least Likely To See A Specialist For Lupus Are Older, Lower Income Patients

Abbott's HUMIRA® (adalimumab) Receives Positive Opinion From European Medicines Agency For The Treatment Of Crohn′s Disease

Scientists Unravel Clue In Cortisol Production

The Role Of Genes Obesity And Alcohol In Hot Flashes

Financial Incentives Can Help To Control MRSA Infections In NHS Hospitals

Scar-free surgery procedures explored

By MALCOLM RITTER, AP Science Writer Sun Apr 29, 10:07 PM ET
PITTSBURGH - A 4-year-old boy lay on an operating table here a few weeks ago with a tumor that had eaten into his brain and the base of his skull. Standard surgery would involve cutting open his face, leaving an ugly scar and hindering his facial growth as he matured.
But doctors at the University of Pittsburgh Medical Center knew a way to avoid those devastating consequences. They removed much of the tumor through the boy's nose.
Since then, doctors in New York and in France have announced they removed gall bladders through the vaginas of two women. And doctors in India say they have performed appendectomies through the mouth.
It's a startling concept and a little unpleasant to contemplate. But researchers are exploring new ways to do surgery using slender instruments through the body's natural openings, avoiding cutting through the skin and muscle.
Many questions remain about that approach. But doctors say it holds the promise of providing a faster recovery with less pain and no visible scars. And in the brain, it can avoid a need for manipulating tissue that could disturb brain and eye function.
For abdominal surgeries, going through the mouth, vagina or rectum would avoid the need to cut through sensitive tissues. And deep inside the body, where tissue doesn't feel lasting pain, the procedures themselves might be less traumatic.
Some abdominal surgeries like bowel operations can require patients to spend a week or more recovering at home. With the natural-opening surgery, the theoretical hope is that "they really can go back to work the next day," said Dr. David Rattner of Massachusetts General Hospital.
"It would be like going to the dentist and getting a root canal," Rattner said. "It's not trivial, but it also isn't disabling."
Sometimes doctors even pass up one natural body opening for another. On the same day they treated the 4-year-old, doctors in Pittsburgh operated on neck vertebrae of an elderly man through his nose. Usually, this operation would have been done through the mouth.
But going through the nose meant the patient could start eating right away rather than waiting a few days. And he avoided the risks of a feeding tube and a surgical hole in his throat to help him breathe, said neurosurgeon Dr. Amin Kassam.
Doctors at the medical center first reached the spine through the nose just two years ago, he said.
They have even removed brain tumors the size of baseballs through the nose, nibbling at them and withdrawing pieces the size of popcorn kernels.
However, entry through the nose isn't feasible for brain tumors in some locations. That's why doctors had to remove the rest of the 4-year-old's tumor another way, by going through the side of his skull. They used an incision designed to hide behind his hairline.
The key to operating through body openings is specialized slender instruments that can be inserted into the natural channels, along with devices that provide light and a video camera lens at the site of the surgery. Doctors watch their progress on video screens as they manipulate the surgical instruments.
Sound familiar? It's much like laparoscopic surgery, which revolutionized the operating room more than 15 years ago. For many operations, long incisions have been replaced with three or four holes, each maybe a quarter-inch to a half-inch wide. That has vastly reduced pain and recovery time.
The natural-opening approach holds the promise of going a step beyond that by eliminating the need for those punctures.
"Getting rid of them completely is going to be not an evolutionary step, but a revolutionary step," said Dr. Marc Bessler of New York-Presbyterian Hospital/Columbia University Medical Center.
He led the surgery in New York that detached and removed a woman's gall bladder through her vagina. The team also inserted laparoscopic instruments into two small incisions in her abdomen, using one instrument to hold tissue out of the way.
A week after that surgery was announced, a French doctor said his team had removed a woman's gall bladder through her vagina without any abdominal incisions. Instead, the team pierced her abdomen with a needle about a tenth of an inch wide. The needle was equipped with a video camera system and also allowed doctors to inflate the abdomen to create a working space.
The surgery, performed April 2 on a 30-year-old woman at University Hospital of Strasbourg, was led by Dr. Jacques Marescaux of the Institute for Research into Cancer of the Digestive System in Strasbourg. In a written statement, Marescaux said the procedure left no abdominal scar.
Meanwhile, surgeons have shown increasing interest in removing brain tumors through the nose over the last five years or so, noted Dr. Gail Rosseau, chief of surgery at the Neurologic-Orthopedic Institute of Chicago.
"This is the dawn of this phase of neurosurgery," said Rosseau, a spokeswoman for the American Association of Neurological Surgeons. "This is exciting, it's new and it may well be better for our patients. In fact, we hope it will be. But it does raise questions."
Cancers can come back if they're not completely removed, she noted. It's too soon to tell whether attacking tumors through the nose leads to a higher rate of cancer recurrence than going through the skull, she said. Concerns like the risk of meningitis from spinal fluid leakage also have to be addressed.
Today, most surgeons would go through the skull to remove baseball-sized tumors, she said, "but a decade from now? I don't know."
As for abdominal surgery, a few procedures have been done in people, but nearly all the research so far has been in animals. There are still plenty of questions and barriers to overcome.
For example, Rattner said, new tools must be developed to perform this kind of surgery. And while it makes sense that people would recover faster from natural-opening surgery than laparoscopic procedures, that hasn't been proven yet, Rattner said.
Then there's the basic question of just what abdominal procedures make sense for a natural-opening approach. For women, Bessler believes the gall bladder and appendix will be among those that will be removed through the vagina.
Rattner questions whether a natural-opening approach for removing those organs offers enough of an improvement over laparoscopy — which can get a patient back to work in four to seven days — to make it worthwhile.
He sees more potential for procedures that replace surgeries that can keep a person out of work for weeks, like removing a kidney, adrenal gland or a portion of the intestine. Or doing obesity surgery.
"It's not going to replace laparoscopic surgery, but it's going to have a niche somewhere," Rattner said. "We're trying to figure out where that niche is going to be."
On the Net:
Abdominal surgery via natural openings:

Sterility, Minus Surgery

Tuesday, May 1, 2007; Page HE02
What's New The Pill. The Ring. The Sponge. They're all temporary means of birth control -- devices you have to keep ingesting or inserting. Even the IUD can't stay in place for more than 10 years.
The only once-and-be-done-with-it option for women has been tubal ligation ("tying the tubes") -- surgery that renders a woman sterile. Now a procedure called Essure, recently approved by the Food and Drug Administration, gives women an alternative. The nonsurgical approach uses a hysteroscope -- a camera-tipped instrument -- to thread two small wires through the vagina, cervix and uterus and into the fallopian tubes. The wires, composed of polyester fibers and metals, cause inflammation and, over time, scar tissue that blocks the fallopian tubes, preventing sperm from reaching eggs. Women can undergo the procedure in 35 minutes in their doctor's office, under local anesthesia; they are advised to rest for 24 to 48 hours before resuming normal activity. Essure is 99.8 percent effective in preventing pregnancy -- a rate similar to that of tubal ligation, according to the manufacturer, Conceptus Inc. of Mountain View, Calif. (gasp!)
Pros and Cons Ellen Whitaker, a gynecologist at the Washington Hospital Center, says "the biggest advantage" of Essure is that it involves no incisions or general anesthesia, which both carry risks. By going through the vagina, she says, you "avoid all the organs in the abdomen." In a tubal ligation, she says, "there's always the possibility of bowel injury, bladder injury . . . which can be very serious."
The biggest drawback, Whitaker says, is the need for X-rays three months after the procedure to confirm the fallopian tubes are blocked. Until then, the patient must use another form of birth control.
Side effects may include pain, cramps and mild bleeding or spotting. There is the risk of infection or a puncture of the vagina or uterus while inserting the hysteroscope. As with tubal ligation, there is also an increased risk of ectopic pregnancy -- a pregnancy that develops outside the uterus.